Super Convergence and the Future of Health and Medicine

Each month, What’s Next Health talks with leading thinkers with big ideas about the future of health and health care. Recently, we talked with Daniel Kraftto explore the potential of exponential technologies.Daniel chairs the Medicine Track for Singularity University and is executive director for FutureMed, a program that explores how fast moving technologies can re-invent health & medicine. The next FutureMed will be held Nov. 3-6 at the Hotel Del Coronado in San Diego, CA.

We live in an exciting, and seemingly ever faster, exponential age, where many technologies, from Artificial Intelligence, social networks, and mobile, to personal genomics, robotics and nanomaterials, when converging together do indeed approach magical qualities as they become faster, smaller, smarter and more powerful at often dramatically decreasing price points.

We often fail to appreciate the breathtaking pace of change and disruption: the first cell phone photo was taken in 1996, we didn’t have Twitter until 2006, and, incredibly, the iPad came out only three years ago. Yet these entities and many others have rapidly transformed our daily lives, and increasingly, elements of health care, mediating powerful new ways to enable prevention, diagnosis and therapy. We still struggle to put some technologies into practice—the price of sequencing a human genome has been dropping at twice the rate of Moore’s law, and will likely reach the $100 level (from ~$2K today) by 2016.

But just a visit to an Apple Store or Best Buy presents a shelf of 25+ "connected health devices" ranging from exercise and sleep tracking devices to scales that can tweet your weight, to smart phone enabled blood pressure cuffs, glucometers and even EKG sensors embedded in phone cases. The dashboards, feedback loops and insights from these low cost and often mobile platforms and related apps have tremendous potential for public health, prevention, diagnosis and optimizing acute and chronic therapy.

With some perspective, we’ll soon realize that what's in our pocket today will seem as anachronistic as the once sleek Motorola flip phone or Palm Pilot of the late 1990s, or picking up a VHS video tape at BlockBuster. I often visit the Computer History Museum in the heart of Silicon Valley and am a bit chagrined to see my once every day tools and toys (Atari gaming console, Apple II computer, non-flat screen TVs…) relegated to the display shelf. Imagine having to go back to using an iPhone One. It would seem terribly slow, with only a few basic apps, low-resolution camera, and limited memory.

It is my hope that many elements of how we deliver and practice health care will soon seem as anachronistic, from wasting time in a physician’s waiting room reading an outdated Readers Digest for a 15-minute visit to filling out the same form about allergies for the 50th time, or yet another HIPPA form.

Many of these technologies (or rather integrated platforms) we take for granted have certainly been in development for decades, if not longer. But they are now reaching the point in terms of their analog to digital transformation, price point, size and abilities that they are "dematerializing" and "disrupting" many traditional products.

The smart phone of today contains what would have in today’s dollars been close to $1M of technology in the early 80s: A $3K video player, $1.3K encyclopedia, $2.6K video camera, $280K GPS, $500K video conferencing, $8K digital voice recorder, and a $6K 5-megapixel camera. The most inexpensive Android Tablets available today have dropped to an astonishing low of $35, and, while not as speedy as the latest Galaxy, they are essentially as functional, and will soon be in the hands of even the most underprivileged across the planet, from our inner cities to rural Africa. This has profound implications for improving education, public health and beyond, as they can facilitate a "digital checkup" from almost anywhere with connectivity, education and insights.

The implications for health care are as powerful and profound as the super-convergence of technologies (AI, robotics, sensors), which have quickly come to together in the last five years to enable "self-driving cars" now on the road and being developed by Google and several car companies.

The challenge and opportunity in medicine is (despite noted regulatory, reimbursement barriers, and often perversely misaligned incentives) to appreciate and leverage many of these "new" technologies, not originally developed for the patient, physician or clinic, to generate improved outcomes across the health care spectrum, with more convenience and in far smarter, more efficient and low cost ways.

As the incentives in our systems shift to "value," and are outcome based, in which physicians and health care systems are incentivized to practice "health care," rather than "sick care," the pace and utilization of these rapidly developing, convergent technologies will continue to spur rapid innovation. The Medical Tricorder XPRIZE competition (I was on the advisory design team) has incentivized and spurred more than 250 teams so far to develop consumer devices for home based monitoring, connecting mobile diagnostics, artificial intelligence and beyond. One entrant (which spun out of our original FutureMed program), Scanadu Scout, is already producing an early version, using crowdsourcing to fund their work and initial clinical trials.

Last week I was fortunate to pick up one of the first Google Glass systems (as part of the Glass Explorers program). It seems (and is) quite magical. I can speak to it and view out of the corner of my eye Google searches, Twitter feeds, and news updates. I can dictate and send emails, take and share photos and videos. I’m sure in a few short years new versions of Glass-like "wearable computing" will seem as quaint as an early iPod…but imagine its potential even today. For example, a surgeon in the operating room can pull up and visualize a checklist or medical images (or share his view with a consulting surgeon to help with a difficult situation), while also being able to access the patient’s vital signs or an up-to-date evidence base. For the primary care physician, less time spent buried in an EMR can potentially enable better, more connected care or facilitate the analysis of a suspicious skin lesion. “OK Glass, compare the image of this patient’s suspicious mole against a database for melanoma”.

For the consumer or patient, having a "heads up health care GPS" can help drive behavior change, from seamlessly tracking diet to enhanced connection to social networks that can support healthy lifestyles. Many anticipate that "apps for Glass" will be as surprising and varied as those that have exploded on the scene for smart phones since the introduction of the iPhone.

As William Gibson once said, and this is certainly the case with my Google Glass today, "The Future is already here… it’s just not evenly distributed." If we anticipate the implications of "where the puck is going" and the possibilities of these technologies as they become more distributed, whether that be cheap "quantified self" wearable body sensors, or low cost genomics that improve drug dosing and selection, or new social networks for connecting, empowering and educating patients and caregivers, we can re-imagine and re-invent many elements of our health care system, which are today still mired in "silos" and practice methods that go back more than 100 years. We can move from a practice of medicine that has been intermittent and reactive to one that has the potential to be engaging, continuous and pro-active, and highly personalized with aligned incentives.

So let's not just predict the future and wait for its arrival. Let's get out there together, try integrating our new tools and create the future. The needs have never been greater but we have an ever more powerful armamentarium at our disposal while being faced with unmet needs and challenges ranging from obesity to a primary care shortage that need novel, convergent and disruptive solutions.

For more on Daniel's ideas, visit What’s Next Health to watch a conversation with Daniel and RWJF's Paul Tarini and view an infographic illustrating the promise of exponential technology.

This commentary originally appeared on the RWJF Pioneering Ideas blog.